Healthcare Provider Details

I. General information

NPI: 1215089586
Provider Name (Legal Business Name): MR. STEVE JOSEPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3144 MORNING MEADOW LN
GRAND PRAIRIE TX
75052-7806
US

IV. Provider business mailing address

3144 MORNING MEADOW LN
GRAND PRAIRIE TX
75052-7806
US

V. Phone/Fax

Practice location:
  • Phone: 214-727-9092
  • Fax: 972-602-3341
Mailing address:
  • Phone: 214-727-9092
  • Fax: 972-602-3341

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: